Takeaways from the MPJE

Author: Justin Shiau, PharmD
Editor: Brentsen Wolf, PharmD

Hopefully, when you chose to take the path of becoming a licensed pharmacist, you already knew about the two exams you must pass to become officially licensed. One is the North American Pharmacist Licensure Examination (NAPLEX), which covers the clinical aspects of pharmacy practice. The other is the Multistate Pharmacy Jurisprudence Examination (MPJE), which I will be going through specifically in this article.

Before we get into the takeaways, I’d like to say that I did not pass the MPJE on my first attempt. Seeing the word “FAIL” on my test record certainly came as a huge disappointment. This was, after all, the literal future of my career, and passing these licensure exams was the last obstacle to becoming a fully licensed pharmacist. If there was one thing that I took away from this experience though, it was that having a support team and a lot of resilience is pivotal during these times. This experience provided me with a vastly different outlook for my future. So, if anyone reading this article finds themselves in a similar situation, know that you’re not alone and that it is possible to pass with some perseverance and a great support system.

Now onto the MPJE takeaways that you’re probably here for. The MPJE is the pharmacy law exam which most pharmacists will tell you is “harder” than the NAPLEX. It is state-specific and has 120 questions, of which only 100 are operational and count towards your total score. The other 20 questions are “pre-test” questions that are likely going to be used for the next year’s MPJE examinations depending on how current test takers perform. You have 2.5 hours (150 minutes) to take the exam and you must complete at least 107 questions for your exam to be graded and receive a score. So, don't spend massive amounts of time on each question! Here's a bit of info on the exam breakdown:

83% of the exam consists of “pharmacy practice” questions. This is the most important section of the three and is where you should dedicate most of your studying time. 15% of the exam consists of “licensure, registration, certification, and operational” aspects of pharmacy law. The last 2% includes “general regulatory processes" which, to be frank, I don’t really think you need to spend too much time on. These are the historical laws like the Durham Humphrey Amendment of 1951 and the Kefauver-Harris Amendment of 1962.

The following tips and tricks were derived from taking the Illinois MPJE, but they can be applied broadly.

1. The MPJE is adaptive… do not let this ruin your testing mindset: Adaptive means that the more questions you answer correctly, the harder the questions will become. This can really mess with your overall mindset. You can get so focused on trying to get the “harder” exam questions that you may miss out on key information or misread some of them. The MPJE has 3 main types of questions – multiple choice, select all that apply (SATA), and K-type (questions with roman numerals and answer choices like “I only, II only, or I and III”). Many people consider SATA and K-type questions to be the “harder” ones and believe that getting more of these types likely means you will pass. Try not to focus on this correlation as it is not 100% evidence-based. I would try to focus more on answering the questions correctly and whether they fall into the “pharmacy practice” category since those are weighted a lot more than the other sections. As an FYI, there are other minor styles of questions such as matching and place in the correct order questions.
2. Pharmacy practice acts and controlled substances acts: Since 83% of the exam includes pharmacy practice, it is super important to study in detail the Pharmacy Practice Act for your specific state. Here’s the one for IL. It’s also important to study in detail the Controlled Substance Act for your specific state. Here’s the one for IL. For IL specifically, I also highly recommend going through the rules that are directly related to the acts (IL Pharmacy Practice Act Rules and IL Controlled Substance Act Rules). Essentially, the difference between the “Act” and the “Rules” is that the rules are sort of like an extended/detailed explanation of why the Act is the way it is and how things are supposed to work.
3. Specific areas to focus on for studying: I’m sure you know this already, but everyone’s exams are going to be different. If you’re wondering how mine was for the IL MPJE, there were a ton of questions in both of my attempts about labeling. These include, but are not limited, to the items that are listed on the prescription (Rx), as well as what goes on the label that is on the medication bottle dispensed to the patient. There were also quite a few questions regarding the different types of pharmacies (i.e., Telepharmacy, Offsite Institutional, Onsite Institutional, etc.). I would recommend really knowing the labeling requirements for those types of pharmacies such as what would go on the label for a “future-use” medication or an “immediate-use” medication (you will know what I am talking about once you start to study!). Another specific area to study is the brand/generic names of most of the controlled substances. I had many scenario-based questions where a patient brought in a prescription for a brand-name drug, so you should be able to recognize whether that drug is a controlled substance and adjust how you answer the question accordingly.
4. Question wording: Really pay attention to what exactly the question is asking. Decipher if the wording within the question is asking “MAY” vs. “SHALL” vs. “MUST”. One minor difference like this can change the answer entirely. The state of IL is terrible with how they write their exam questions. Unlike the NAPLEX, they're not written by people certified through the NABP. So, you should make sure to read each one carefully.
5. Federal vs. state-specific: On top of the state-specific laws, you should also be studying for the federal portions that may appear on the exam. I believe the MPJE focuses more on state-specific laws since most of them are more stringent than federal laws, but that really depends on your specific state. For IL, many of the laws in the practice act and controlled substance act are more strict than federal, so a lot of the questions in the exam should be answered according to the state. Pay attention to whether the question asks, “In your jurisdiction” or “Federally…”. Otherwise, if the question doesn’t specify (which 99% of the time it won’t), go with the stricter law.
6. Helpful study resources/tools: You should absolutely utilize external study resources. Many of my friends (myself included) ended up purchasing the practice examination through NABP for $75. To be honest, I don’t think it was as helpful as some other resources that I will be listing here. Many of the questions were outdated, but it does help you get accustomed to the exam format. RxPharmacist.com has a great online resource if you’re willing to pay for it. It has courses for each state MPJE and a huge practice exam at the end that provides helpful explanations! I’ve also heard great things about pharmacyexam.com. Each question provides detailed explanations and where to find the answers.
7. For Illinois – the “Ed Rickert Packet”: If you’re planning to take the MPJE in IL, you may have heard about the infamous “Ed Rickert Packet”, which is commonly referred to as the “one-stop-shop” or “go-to study material” for the state of IL. Many test-takers use this resource alone and pass on their first try. If you can pull that off, then definitely kudos and claps to you! Take what I am saying here with a grain of salt. I purchased this resource and did find it quite helpful. However, I don’t think it should be your only resource. I would use it more as co-study material to the actual laws, rules, and regulations. There were a few errors within the packet, and some of it was outdated. But again, it's still a great resource to use!

I could go on and on about this (awful) examination and how I think there really needs to be a change in the formatting. Regardless, I hope this helps to provide you with some helpful insight into the “harder” licensure exam. Good luck!

Author Bio: Justin Shiau is a current PGY1 Pharmacy Resident at Northwestern Medicine Central DuPage Hospital. Justin graduated with his Doctor of Pharmacy degree from the Southern Illinois University of Edwardsville in May 2022 with a specialization in education. In his free time, Justin likes to run, cook, and game with his buddies. Connect with him via LinkedIn here!